We write to you on behalf of the Midwives Association of Ireland (MAI), a professional association (not a trade union) of midwives in respect of International Day of the Midwife, 5th May 2020, in the year of the WHO Year of the Midwife and Nurse.

Firstly though, we wish to pay our thanks to you for your leadership throughout the COVID-19 pandemic. We acknowledge and pay tribute to you and the team for the agility and responsiveness achieved within and around the Irish Health Services as a whole, in recent months. We value your honesty in acknowledging that some of these gains have been made by reducing bureaucracy and by having a real sense of commitment within the HSE and the wider healthcare system. We wholeheartedly support your suggestion that we need to look at how healthcare is delivered in Irelandin the future.

Like the International Confederation of Midwives (ICM), we envision a national maternity service whereby every childbearing woman has access to a midwife’s care for herself and her newborn. As midwives working through this pandemic, we have seen dramatic changes to how we provide care. One-to-one interactions with women are key to the philosophy of midwifery care (NMBI 2015) and this relationship is valued by both women and midwives alike. However, through necessity, we have adjusted our practice and found innovative ways to protect that relationship.

We hope going forward that some innovative practices might be expanded, for example whereby some units expanded their community midwifery care and where others acknowledged that normal risk women didn’t and don’t require assessment by a doctor and can be cared for by utilising thereadily available skilled midwifery force at little disruption or increased cost. We have seen an increased interest in the HSE homebirth service, safely and ably provided by the HSE sub-contracted self-employed community midwives (SECMs), a welcome change in Ireland.

All of the above examples are both aspirations and deliverable objectives of the National Maternity Strategy – Creating a Better Future 2016-2026 (launched by the then Minister for Health, L. Varadkar) and which shares the same ethos and principles of Sláintecare (2017), which referenced the aforementioned document as the blueprint for Maternity Services. We note that many of the deliverables of the National Maternity Strategy had become been bogged down by the same bureaucracy you mentioned.

Going forward, the Midwives Association of Ireland (MAI) would welcome the continued approach (as has worked for Covid -19) and that midwives as key stakeholders in maternity care would be acknowledged and utilised as essential members of the team at the discussion table for change.

Attached are 3 documents, the MAI has published in the last 18 months which provide an insight and understanding of issues that are crucial for the development of midwifery in Ireland.

We would be very happy to meet with you or any your team at any stage, should you/they wish to discuss any of these issues or related documents in more detail as to how midwifery can be more effectively used in Ireland to help improve maternity services for all.

Thank you again for your time and for all of your work to date.Kind regards,